Mandate

Document Sample
Mandate Powered By Docstoc
					FOR PAYMENT TO SUPPLIERS/CONTRACTORS
                                                                              IN TRIPLICATE
PROFORMA FOR COLLECTING PAYMENT THROUGH ELECTRONIC MODE INCLUDING
ELECTRONIC FUND TRANSFER (EFT) & ELECTRONIC CLEARING SYSTEM (ECS)

                                                                       (to be submitted in triplicate)
1    VENDOR /SUPPLIER/CONTRACTOR/
     CUSTOMER’S NAME & ADDRESS                             :
     (with Telephone No & Fax No):
2    PARTICULARS OF BANK ACCOUNT                          :
        A. BANK NAME                                      :
        B. BRANCH NAME                                    :
         (Including RTGS CODE)
        ADDRESS                                           :

       TELEPHONE NO AND FAX NO                   :
       C. 9-DIGIT CODE NUMBER OF THE             :
          BANK & BRANCH
          (Appearing on the MICR cheque issued on
          the bank) or 5 digit code No of SBI
       D.ACCOUNT TYPE                           :
          (S.B Account/Current Account OR Cash
          Credit with code 10/11/13)
       E. LEDGER NO/LEDGER FOLIO NO               :
       F. ACCOUNT NUMBER(CORE BANKING)
            & STYLE OF ACCOUNT                     :
       (As appearing on the Cheque Book)
4.    DATE OF EFFECT
      I hereby declare that the particulars given above are correct and complete. If the transaction is
      delayed or not effected at all for reasons of incomplete or in correct information, I would not hold the
      user institution responsible. I have read the option invitation letter and agree to discharge
      responsibility expected of me as a participant under the scheme. Any bank charges levied by the
      bank of such e-transfer shall be Born by us.

      Date :-                                                  (_________________________)
                                                               Signature of the Customer/Vendor
                                                               /Supplier/Contractor

           Certified that the particulars furnished above are correct as per our records.


                                                         (_________________________________)
                                                          Signature of the Authorized Officials
                                                                  from the bank

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:56
posted:11/12/2011
language:English
pages:1